Glomerulonephritis in Children

What is glomerulonephritis?

Glomerulonephritis is a type of kidney disease that involves the glomeruli. These are very small, important structures in the kidneys that supply blood flow to the small units in the kidneys that filter urine called the nephrons. During glomerulonephritis, the glomeruli become inflamed and impair the kidney's ability to filter urine.

What causes glomerulonephritis?

Glomerulonephritis is caused by several different disease states, including the following:

Wegener vasculitis. A progressive disease that leads to widespread inflammation of all of the organs in the body.

Henoch-Schönlein purpura. A disease usually seen in children that is associated with purpura (small or large purple lesions on the skin and internally on the organs) and involves multiple organ systems.

A form of inherited glomerulonephritis called Alport syndrome, which affects both men and women; men are more likely to have kidney problems. Treatment focuses on preventing and treating high blood pressure and preventing kidney damage.

In children, a common cause of glomerulonephritis is from a streptococcal infection, such as strep throat or upper respiratory infection. Glomerulonephritis usually occurs more than one week after an infection. This is often referred to as acute poststreptococcal glomerulonephritis or APSGN.

What are the symptoms of glomerulonephritis?

The following are the most common symptoms of glomerulonephritis:

Dark brown-colored urine (from blood and protein)

Sore throat

Diminished urine output

Fatigue

Lethargy

Increased breathing effort

Headache

High blood pressure

Seizures (may occur as a result of high blood pressure)

Rash, especially over the buttocks and legs

Weight loss

Joint pain

Pale skin color

Fluid build up in the tissues (edema)

The symptoms of glomerulonephritis may look like other conditions and medical problems. Always consult your child's doctor for a diagnosis.

How is glomerulonephritis diagnosed?

In addition to a thorough physical exam and complete medical history, your child's doctor may recommend the following tests:

Throat culture

Urine tests

Blood tests

Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.

Renal ultrasound (also called sonography). A noninvasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.

Renal biopsy. A procedure during which a small sample of tissue is taken from the kidney through a needle. The tissue is sent for special testing to determine the specific disease.

What is the treatment for glomerulonephritis?

Your child’s health care provider will figure out the best treatment based on:

How old your child is

His or her overall health and medical history

How sick he or she is

How well your child can handle specific medications, procedures, or therapies

How long the condition is expected to last

Your opinion or preference

If glomerulonephritis is caused by a streptococcal infection, then treatment will be focused on curing the infection and treating the symptoms associated with the infection. Treatment will depend on the underlying cause. Therefore, treatments focus on slowing the progression of the disease and preventing complications.

Treatment for glomerulonephritis may include:

Fluid restriction

Decreased protein diet

Decreased salt and potassium diet

Medication, such as:

Diuretics

Blood pressure medications

Phosphate binders. Medications to decrease the amount of the mineral phosphorus in the blood.

Immunosuppressive agents

Dialysis. A medical treatment to remove wastes and additional fluid from the blood after the kidneys have stopped functioning. Dialysis may be required for short-term or long-term therapy.

If glomerulonephritis does not resolve, long-term kidney failure may need to be addressed.